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New Year Presents Opportunities and Challenges for Behavioral Health System

Debra L. Wentz, Ph.D., CEO of NJAMHAA, recently shared the following insights on opportunities and challenges for the behavioral health system with Mental Health Weekly, a national trade publication:

“Hope is always on the horizon with the advent of a new year. What I find especially exciting is Congress’ focus on private-public partnerships to accelerate the discovery, development and delivery cycle in the United States to foster innovation and bring new treatments and cures to children and adults with mental health and substance use disorders. Under the leadership of New Jersey’s own Congressman Leonard Lance and the Energy and Commerce Committee, New Jersey’s and the nation’s pharmaceutical and biomedical industry and private corporations are partnering to research the causes of schizophrenia and bipolar disorder, as well as investing in personalized medicine, which also offers great potential for early intervention and for eliminating the trial-and-error approach by targeting subgroups for different treatments based on genetics.

While passage of the Mental Health Parity and Addiction Equity Act (MHPAEA) was groundbreaking, there are limitations that behavioral health stakeholders find disappointing. The law does not mandate that insurance companies cover mental health and substance use treatment services. Rather, it only requires insurance plans that cover these services to do so with coverage limits and out-of-pocket expenses that are quantitatively and qualitatively equal as coverage for medical and surgical care. Despite this progress as well as that provided through the mandated parity coverage of mental health and substance use services of all those who fall under the Medicaid Expansion and the Healthcare Marketplace, how comprehensively the MHPAEA is implemented remains a challenge as insurers interpret medical necessity more narrowly than the recovery-oriented and habilitative services necessary to keep those with mental health and substance use challenges well. In fact, in order to move closer to the day when mental illnesses and substance use disorders are treated just like physical ailments — not only clinically, but also in attitude, we still have mountains to climb … but at least, we already are in the foothills!

A positive sign is the greater focus on mental illnesses and substance use disorders — in New Jersey, from Governor Christie’s clear commitment to addiction prevention and treatment and the increased awareness of the illnesses, as well as suicide, following the death of actors Philip Seymour Hoffman and Robin Williams. The challenge will be to keep a sustained sense of urgency in providing adequate visibility for the issues, funding for treatment, and necessary services, including housing, employment, transportation and other supports, without a tragedy such as opioid overdoses, school shootings or more suicides to propel the field forward.

To call eliminating the barrier of stigma against individuals with mental and substance use disorders a mere challenge is to understate how much public and political will it will take to bring funding levels and mind-sets to the point that these illnesses are regarded simply as other diseases. Given the high prevalence rates of behavioral health disorders, we will build on progress and demand fair rates and adequate treatment for services, housing, employment and other supports to keep our providers fiscally healthy so they can serve children and adults with emotional and behavioral disorders and mental illnesses and substance use disorders well and in recovery in 2015 and beyond.


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